Clinical Research at Park Surgery

This is the general information page - for specifics for individual studies including updates and conclusions when available - click here

The National Institute for Health Research (NIHR) is the research arm of the NHS. The NIHR funds health and care research and translates discoveries into practical products, treatments, devices and procedures. They ensure the NHS is able to support the research of other funders to encourage broader investment in, and economic growth from, health research. They work with charities and the life sciences industry to help patients gain earlier access to breakthrough treatments and they train and develop researchers to keep the nation at the forefront of international research.

Findings from research studies help all GPs, nurses and other health professionals provide the most appropriate and up-to-date care. Park Surgery is pleased to be part of the National Institute for Health Research Clinical Research Network (NIHR CRN) for Kent, Surrey and Sussex. This means we are part of a network of General Practices who host medical research on a regular basis. Patients registered with this practice have an opportunity to help shape the future of health care by taking part in research projects.

This link will take you to the specific NIHR web pages for Kent, Surrey and Sussex. Please Click Here

They regularly produce a newsletter whose recent edition featured a piece about Dr Elizabeth Fisher (Research Lead for Park Surgery) and the research work going on here. Please Click Here

How can you help and take part?

There is a campaign running on social media at the moment (19.12.17) around patient and staff experiences of research within the NHS - please follow the links to access this information on Twitter or Facebook.

Previous research participants from Kent, Surrey and Sussex have stated that helping other people was a significant reason which drove them to take part. It’s clear that patients know that the treatments we have today are as a result of people taking part in research in the past.

As a member of the Research Network, we will from time to time invite patients to take part in research studies. You will always receive clear information about what taking part in any research study would involve. You will have the opportunity to ask questions and obtain further details about the study with no obligation to take part. Participation in any research project is entirely voluntary and you can withdraw at any time throughout any study. Declining or withdrawing from any study will not affect your medical care in any way.

There are various ways a patient can become involved in studies at Park Surgery and requirements vary from study to study.

You may be asked by a member of the Practice to consider taking part in a particular research project; Your participation could involve:

Filling in a questionnaire

Talking to a researcher about your views/symptoms

Letting the researcher look at your medical notes

Trying a new treatment, therapy or device

Experiencing new combinations or timings of treatments

Providing samples for testing (blood, urine, breath etc.)

You may be sent information through the post if we feel you may be a suitable participant.

You may read information about a current study in the patient waiting room or on the surgery website and wish to take part.

If you do agree to take part in a study, you will be asked to sign a consent form. This will clearly state which part of your notes (if any) may be looked at for the purposes of the research study. Nobody from outside this practice will be given your contact details or have access to your medical records without your prior consent. Everyone who has access to your records, or any of your details for research, is bound by a strict code of conduct to keep your data confidential. Where possible, all data collected from you for research purposes will be coded with a number rather than your name.

You will not be asked to take part in a large number of studies; Most researchers are very specific about the criteria that that people need to meet in order to enter their study. Usually this means that only a small number of our patients will be suitable for any one study.

Please also access the UK Clinical Trial Gateway for further details on NIHR portfolio studies(Please Click Here) or call the Clinical Research Network on 01273 641417.

What is it like to participate in research?

Patient experience survey carried out by the Clinical Research Network from Kent, Surrey and Sussex in 2015 showed that:

96% thought research should be considered a normal part of NHS care.

The vast majority of participants had a very satisfying experience, from their intial introduction to the research to completing the study.

98% found staff friendly and helpful.

Participants felt well valued and supported with easy access to staff.

Participants felt well informed about the study with time given to consider and make informed choices.

Most people would be happy to take part in a study in the future and/or recommend to others.

Safety considerations

Before a research project starts, it is looked at by various organisations to make sure it is OK for you to take part. These include an NHS Research Committee and the NHS organisation responsible for your care. They make sure any risks have been looked at, that the study is of value to patients and the NHS, and that it respects the rights, safety and wellbeing of those taking part.

They also review projects regularly after they have started to make sure they continue to be safe.

Award-Winning Research Team at Park Surgery

We have been accredited by the Royal College of General Practitioners as ‘Research Ready’. This means we are prepared to participate in the high quality research studies that the NIHR CRN offers.

In 2016, we were awarded Highly Commended in national research awards run by the National Institute for Health Research (NIHR) Clinical Research Network and the Royal College of General Practitioners (RCGP). For their website with all the details, Please Click Here

In addition, we were the highest recruiter nationally for the Garfield Heart Study and among the highest for the CANDID research project (see the Research Studies tab for specific details of all our projects).

This photo shows some of the Research Team at Park including Dr Elizabeth Fisher (Research Lead, front row in the middle), other GPs, nurses and administrative staff. Many other staff not shown are also actively participating.

There is a key requirement for staff members involved in clinical research to have undertaken Good Clinical Practice (GCP) training to ensure they are qualified to deliver research within the General Practice setting. GCP training provides the standard and guidelines to which all research is conducted. All staff involved in the recruitment of patients to research studies possess up-to-date GCP certification.

Research Study Summaries

This page gives details of all the research projects Park Surgery has recruited for over the years and those still actively recruiting.As research findings and their implications are made available by the study teams they will be added here, so if you've been involved in a particular study you can check back here later on to see updated information regarding 'your' study. Studies are listed alphabetically by acronym.

3C

This study aimed to find out what symptoms, measurements and characteristics can be used to predict which patients with a cough and suspected lower respiratory tract infection (LRTI) go on to develop complications, i.e. pneumonia severe enough to require hospitalisation. Over 30,000 patients in total were recruited from across the country.

ALPHA

The aim of the study is to find out the most effective treatment for chronic hand eczema, and will compare the drug Alitretinoin with the usual treatment of UVA phototherapy/drug treatment with Psoralen. It is recruiting at East Surrey Hospital (ESH), Redhill. GP practices are supporting recruitment by displaying copies of the study poster (so patients can contact the study team directly). In addition to displaying posters, patients with severe hand eczema can be referred to ESH.

BARRIERS TO UPTAKE OF INTRAUTERINE CONTRACEPTION

Intrauterine contraception (IUC) is safe, long-lasting and highly effective. Despite this, there is a low level of usage for contraception and this study was designed to investigate barriers for patients and clinicians. Patients reported fears about the risk of the method and dislike of a device in the womb. The long-acting nature of the method also made it unattractive to some users. For practitioners, organisational barriers were reported as presenting a challenge in terms of practice premises, staff time and training to fit. Recommendations: Better and more relevent information about IUC which addresses the concerns of users is required for patients. Increased levels of training among those not trained to fit could increase recommendations of IUC as a suitable contraception method. Improved access to training for clinicians in also needed to increase pool of fitters and make IUC more easily available in General Practice.

CANDID

This study seeks to work out which of the symptoms and examination findings are the most effective in predicting lung or colon cancer. It aims to recruit a total of 20'000 patients who consult their GP - half with lung symptoms and the other half with low bowel symptoms.

Child-Parent Screening Study: Familial Hypercholesterolaemia

This study looked at the feasibility of screening for familial hypercholesterolaemia (FH), an inherited condition that affects around 1 to 2 in every 250 people in the UK. It can cause abnormally high cholesterol levels. It doesn't usually cause any noticeable symptoms, but people with FH aged between 20 and 40 are 100 times more likely to have a heart attack than other people their age.

UK researchers tested 10,095 one-year-olds to explore the feasibility of screening for FH. They tested the toddlers at the same time they had routine vaccinations at the age of one. Researchers found 28 children with FH. The parents of children with FH were then also tested. The study found not all children with an FH mutation had high cholesterol, however, and some with high cholesterol did not have a known FH mutation. This means FH mutation testing alone would not be a useful screening test, so the researchers suggest testing cholesterol levels first. The approach used in the study does have the added benefit of identifying parents with FH who didn't realise the condition ran in their family. Once FH is diagnosed, it is relatively straightforward to treat through making lifestyle changes and taking drugs known to reduce cholesterol, mainly statins. This research will help inform the UK's National Screening Committee when considering whether the benefits of screening for FH outweigh the harms.

COMPASSION STUDY

This study involved NHS staff completing a survey in their own time. Data gathered will be used to develop a new questionnaire measure of compassion towards other people and compassion towards the self.

CONTACT - Low dose colchicine or naproxen treatment for acute gout

Gout is the most prevalent inflammatory arthritis. It is largely managed in primary care but with varying treatment regimens. Treatment is most frequently with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or oral colchicine. Oral colchicine has been used to treat acute gout for many years although high-doses can cause intolerable gastrointestinal side-effects. Low-dose colchicine is thought to be as effective and better-tolerated and is now recommended. This study primarily aims to compare the effectiveness of low-dose colchicine and naproxen for reducing pain in adults consulting their GP with acute gout. The trial will also look at side-effects, cost-effectiveness, adherence to treatment and time taken to reduce pain.

FLUENZ

Safety surveillance of the influenza vaccine (QLAIV) fluenz tetra in children and adolescents during the early 2015/2016 influenza season in England. Practices took part by giving information to patients during the flu season.

GARFIELD

The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF Registry) is a pioneering real-world prospective registry - one of the largest in the field of non-valvular atrial fibrillation (AF). With an enrolment of 57,262 patients, GARFIELD-AF aims to enhance understanding of stroke prevention in patients with non-valvular AF worldwide and help in defining future treatment strategies that may eventually influence patient outcomes.

GETTING DOWN TO COPING - Online self-management after treatment for prostate cancer: a feasibility study

The study represents a four week, online, self-management intervention for men experiencing distress related to disease and treatment side-effects of prostate cancer. A film called Getting Down to Coping®was made to be shown to participants in a self-management programme which is being tested by the University of Surrey team in a randomised controlled trial. The programme teaches men practical, physical and cognitive ways to help them cope with the urinary symptoms they experience after radiotherapy treatment for prostate cancer. Seven men speak candidly and helpfully in the film about their personal stories and coping realities.

GP Conversations

This study is designed to understand better the conversations between patients and their GPs. Researchers from the University of Surrey, University of Cambridge and University College London are interested in how patients describe and talk to their GP about new symptoms, and how doctors draw out further information about patients' symptoms in consultations. This study may help to improve conversations between patients and their GPs. This could lead to illnesses being diagnosed and treated more quickly.

HEAT

H. pylori are spiral-shaped bacteria that grow in the digestive tract and have a tendency to attack the stomach lining. The HEAT trial aims to find out whether eradication of H.pylori will prevent ulcer bleeding, in patients taking low-dose aspirin. Participants attend one screening clinic at the practice and H.pylori-positive patients receive one week's worth of eradication medication or matched placebo.

JOIN DEMENTIA RESEARCH

LIFESTYLE, HEALTH & WELLBEING

This study will provide valuable information to help the NHS make decisions about what type of lifestyle interventions to provide to people with mental health problems in the future. To obtain this information this study aims to recruit 2000 people who have received help for mental health problems.

Using a brief and simple survey method and a large group of people with mental health problems, the study team aim to measure a number of health related behaviours and health risk factors. With an additional aim to judge the willingness of people with mental health issues to modify these risk factors (such as interest in giving up or quitting smoking; interest in doing more exercise or improving diet).

Professor Simon Gilbody who is a Consultant Psychiatrist and a researcher at the University of York is leading the study.

Eligible patients have been invited to participate by letter from the surgery.

MINDSHINE

Stress experienced by NHS staff can have many negative consequences to them as individuals, to their patients and to the healthcare sector more broadly. At an individual level, health care staff may experience reduced self-esteem, fatigue, poor job-satisfaction and burnout. In turn, this can negatively impact patients via a reduced quality of patient care and prolonged recovery for patients and stress, anxiety and depression are significant causes of sickness absence among NHS staff. As such, it is considered very important to provide evidence-based interventions to support the wellbeing of NHS staff. The purpose of the present study is therefore to investigate the effectiveness of two existing interventions in improving wellbeing and reducing psychological distress among NHS staff.

PRIMIT

The PRIMIT study covers the development and clinical trial of a website designed to reduce transmission of cold and flu viruses in households. The website can be used during normal seasonal flu and in the event of pandemic flu.

The website has four weekly sessions which encourage users to plan and learn how to use simple techniques to avoid catching and passing on viruses. Findings from the pilot phase showed highly significant increases for both intention to perform and the actual behaviour of the main technique, at both the one and three month follow-ups.

Results to date: 16,908 participants were followed up. The intervention reduced transmission of respiratory tract infections both to and from the index person.

Conclusions: In non-pandemic years an effective internet intervention designed to increase hand-washing could have an important impact in reducing infection transmission. Paper published in Lancet.

RenewedOnline

Researchers at the University of Southampton have made a website which supports people who have had breast cancer, bowel cancer or prostate cancer, or people on active surveillance (people monitoring prostate cancer symptoms). There is advice on improving physical health and help with feelings of tiredness, worry or stress and concerns about cancer. The current project aims to evaluate the website for improving quality of life in cancer survivors.

Eligible patients have been invited to participate by letter from the surgery.

Safety Monitoring of Flu Vaccination 2017/2018

Surveillance of Side-Effects from this year's Seasonal Influenza Vaccine - Patients were asked to report any suspected adverse reactions following routine flu vaccination as part of the monitoring carried out at GP practices annually by the company supplying the vaccine. Report cards were given out to Park patients vaccinated early in the season and they were asked to call a Freephone number to report as necessary. Rates of side effects being reported will be compared with those reported last year. The aim of this data collection is to rapidly identify and evaluate any potential new safety concern each influenza season to mitigate risks before the peak period of seasonal immunisation.

Results reported by the study team for the entire UK study: A total of 14 (1.4%) vaccinees reported at least 1 suspected adverse reaction following vaccination. The overall reporting rate of adverse reaction was 4.0%. The reporting rates were lower than those reported in the previous year. The safety analysis of suspected adverse reactions did not identify any reporting pattern by type, frequency or severity.

Overall, this safety study did not suggest any clinically significant change in what is known or expected.

SNIFS

This study looked at methods of treating chronic sinus infections. The study recruited patients with recurrent or chronic sinusitis and patients were randomised to one of the following four treatment options:

nasal irrigation,

steam inhalation,

a combination of both

or normal treatment

Results to date:

No effect of steam; Irrigation helped: 10 point clinically important improvement.

Conclusions: Advice to use steam inhalation for chronic or recurrent sinus symptoms in primary care was not effective. A similar strategy to use nasal irrigation was less effective than prior evidence suggested, but it provided some symptomatic benefit.

StartRight - Getting the right classification and treatment from diagnosis of Diabetes

A leading diabetes consultant at Surrey and Sussex Healthcare NHS Trust Dr. Benjamin Field and his team are studying patients who have been recently diagnosed with diabetes to find out whether early testing of blood samples can help to improve diabetes treatment. Recruitment is restricted to patients aged 18-50 who have been diagnosed within the previous 12 months. This study aims to achieve more accurate early classification of diabetes and identification of which patients will rapidly require insulin treatment.

STILTS 2

This is an observational study which aims to recruit a substantial cohort of thin people (2000) to identify genes that contribute to thinness and may provide further insights into the regulation of body weight and obesity resistance. This may inform rational preventative and therapeutic strategies for weight disorders.

SYMBAD

The University of Sussex study team are trying to establish what the best medication is for the management of agitation and/or aggression in people living with dementia. It is quite common for people who suffer from dementia to have such symptoms and they can cause problems. These symptoms are associated with lower quality of life. Symptoms of agitation comprise restlessness, pacing, shouting and verbal or physical aggression. Symptoms are difficult for the person with dementia and for their family and carers. There is a wide choice of medicines available to treat symptoms of agitation, but it is not clear which treatments are best in people who have dementia.

If you or someone you care for is eligible for this study, your GP may discuss participation with you.

TIME

The study aims to find out if antihypertensive therapy taken in the evening has improved cardiovascular outcomes compared with more conventional morning dosing. Patients took part by signing up online.

VACCept Survey Study

This study aims to find out what women know about Human Papillomavirus (HPV) and what they feel about HPV vaccination. If you are between 30-45 years old and attending the surgery for a routine smear, you may be asked to participate. Despite cervical smear testing, cervical cancer still affects a significant number of women. High-risk HPV viruses cause nearly all cervical cancer and vaccines are available which work best if given prior to any sexual activity. In the UK, girls aged 12-13 can be vaccinated in school. Older women cannot get the vaccine on the NHS. Some countries offer the vaccine to older women as it may protect if the woman is not already been exposed. However, not all women offered the vaccine choose to have it and reasons around this choice may enable the set-up of a clinical trial offering HPV vaccination to women attending for cervical screening in the UK.

Patient Research Experience Survey

If you have taken part in clinical research we would appreciate your feedback. Please can you complete an anonymous questionnaire about your experience so we can improve our service. Please fill in our survey online via bit.ly/PRES2018

International Clinical Trials Day - 20th May

Park Surgery celebrates and has a stall in surgery entrance to raise awareness about research in the NHS. Come and join in! Information available about what participating could mean. Register your interest with reception if you feel inspired to take part and play a role in projects directly or by championing research work in general.

#IAmResearch will take you to the NHS National Institute of Health Research (NIHR) Twitter feed around this campaign.

Park Surgery Highly Commended in Research Awards

In the recent NIHR Partnership Awards, Park Surgery was highly commended in the category of 'Best contribution to commercial research'. This was given for our success in recruiting for the Flu Safety Surveillance Study during Autumn/Winter 2017. Our certificate is proudly on display in the first floor waiting room. See the whole story of the research awards here

Of the 147 GP Practices recruiting nationwide, Park Surgery were the second-highest. Many thanks to all our ladies who took part. (January 2018)

HEAT Study

News update

Nov 2017

click for the full story

TIME Study discussed on BBC Radio 4 Inside Health Programme (8th March 2017)

We recently asked eligible Park patients to enrol in a research project into what time of day to take blood pressure medication for maximum benefit (TIME study). The TIME study has been discussed on the Inside Health programme (Radio 4, 8/3/17 3.30 pm) and can be listened to at by clicking here (Please be aware that other topics in the programme include organ donation and post mortems.)

We would like to thank all patients who helped with this project – it is only with the support of our patients that we can contribute to such important research work generally.

Recruitment to research through GP practices tops One Million!- (9th February 2017):

"We are writing with news of a significant achievement for NHS research. We have had news that we have surpassed one million participants in primary care research.

Over the years, these studies have looked at a healthier lifestyle, disease diagnosis and prevention and management of long-term illnesses, such as diabetes.

Simon Denegri is the NIHR National Director for Patients and the Public in Research, he said:

This is fantastic news. The nature of the health challenges facing the UK means that GPs, in partnership with patients and carers, have a crucial role to play in developing treatments of patient benefit. That over one million people have volunteered to participate in clinical studies is a mark of how successful this partnership has become. The NIHR hopes that many more people and their families will be encouraged by this to also come forward and help us do more life-saving work. Research cannot happen without them.

There is further information on the website including a Q&A with the Royal College of General Practitioners. You can also follow the story on Twitter using #NHSresearch and #oneinamillion

Thank you and congratulations for all your past and ongoing efforts to support research. "

Events

Research across generations, 2 Sep 2017 - 10:00 to 15:00

A free event about clinical research that people of all ages have been involved with is taking place at the Royal Surrey County Hospital in Guildford on Saturday 2 September.

There will be a screening of ‘People are Messy’, a Theatre of Debate film (running length is one hour) that engages its audiences in an informed debate around patient and public involvement in health research. The event will also feature a Research Fair where you can find out more about how patients and the public can help shape and deliver improvements in health.

You will need to register to attend the event you would like to attend. Check out the People are Messy event page for more information.

This is one of a series of National Institute of Health Research (NIHR) events taking place around the country, as part of the new I Am Research campaign to celebrate International Clinical Trials Day 2017.